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Mobile health apps to disintermediate PHRs?

It's a common question for those in the mobile health space -- right up there with "Who Pays?" and "How will the FDA view my app?" For a few years many hoped personal health records (PHRs) like Google Health and Microsoft HealthVault would act as the central repositories for health data streaming in from various personal health devices, sensors and apps. Not so much anymore.

"Vendors of HIT products and PHR tools will play an increasingly important role in mapping out the landscape of personal health information management," writes Patti Brennan, the director of Project HealthDesign, "but nowhere on the terrain do I see a single vendor for a freestanding PHR taking hold! It’s time to stop looking for the turnkey PHR and start realizing that the idea of a single PHR as the sole point of intersection for all data, services, and visualization tools needed by a lay person to manage his or her health is so 1999. It’s time to recognize that the suite of tools needed by one person to manage asthma or handle diabetes might well be quite unique to that person’s life process, health state and personal preferences, and quite different than that needed by another."

As the director of Project HealthDesign, Brennan's perspective on the issue of PHRs is key: Project HealthDesign "is forging a new vision of personal health records (PHRs) by exploring practical ways to capture and integrate patient-recorded observations of daily living (ODLs) into clinical care."

Of course, for some ODLs, practical ways for capturing observations and personal health data already exist.

This week I sat down with Michael Sheeley, co-founder of FitnessKeeper, the makers of the popular RunKeeper app for iPhone and Android users. RunKeeper now has more than 2 million users tracking their runs and other fitness activities by using the GPS sensors on their smartphones. RunKeeper recently announced plans to add sleep data from Zeo's personal sleep coaching service. RunKeeper has already integrated with WiThings' WiFi-enabled WiScale to auto-update user's weight every time they step on the scale.

Sticky mobile applications like RunKeeper that are willing and savvy enough to find complementary services to partner with are building the personal health platforms that we all hoped Google Health and Microsoft HealthVault might turn into someday. As Brennan notes, these partnerships will create a distributed model for PHRs that are better tailored for different groups of users. RunKeeper's users may include sleep, weight and other data because it has an impact on their running. A similar app and portal for diabetics may integrate data from different sources.

"When you look at larger systems [like Google Health] that offer to put health information into one big database," Sheeley said, "there's no incentive for users to do it. There is no instant gratification for entering that data. There's no reward. And it's not fun."

And while instant gratification, rewards and fun are likely key for many successful mobile health and fitness applications, most still aren't working toward what Project HealthDesign includes as part of its mandate: Integrating these patient observations into clinical care.

"We don't have an interest in doing that any time soon," Sheeley said. "For us, the focus is on the consumer play and helping users understand their own fitness while making it fun. We have no near term plans for making this data available for hospitals or physicians. That said, if a user wants to share their fitness information with their doctor, sure, they can do that during a doctor's visit."